Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Clinical analysis of early reoperation cases after orthognathic surgery

악교정수술 후 조기 재수술 증례의 분석

  • Lee, Ju-Hwan (Department of Oral and Maxillofacial Surgery, Graduate School, Seoul National University) ;
  • Lee, In-Woo (Department of Oral and Maxillofacial Surgery, Graduate School, Seoul National University) ;
  • Seo, Byoung-Moo (Department of Oral and Maxillofacial Surgery, Graduate School, Seoul National University)
  • 이주환 (서울대학교 치의학대학원 구강악안면외과) ;
  • 이인우 (서울대학교 치의학대학원 구강악안면외과) ;
  • 서병무 (서울대학교 치의학대학원 구강악안면외과)
  • Published : 2010.02.26
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Abstract

The factors influencing the relapse and recurrence of skeletal deformity after the orthognathic surgery include various factors such as condylar deviation, the amount of mandibular set-back, stretching force by the soft tissues and muscles around the facial skeleton. The purpose of this report is to recognize and analyze the possible factors of reoperation after orthognathic surgery, due to early relapses. Six patients underwent reoperation after the orthognathic surgeries out of 110 patients from 2006 to 2009 were included in this study. In most cases, clincal signs of the insufficient occlusal stability, anterior open bite, and unilateral shifting of the mandible were founded within 2 weeks postoperatively. Although elastic traction was initiated in every case, inadequate correction made reoperation for these cases inevitable. The chief complaints of five cases were the protruded mandible combined with some degree of asymmetric face and in the other one case, it was asymmetric face only. Various factors were considered as a major cause of post-operative instability such as condylar sagging, counter-clockwise rotation of the mandibular segment, soft tissue tension related with asymmetrical mandibular set-back, preoperatively existing temporomandibular disorder (TMD), poor fabrication of the final wafer, and dual bite tendency of the patients.

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References

  1. Paulus GW, Steinhauser EW. A comparative study of wire osteosynthesis versus bone screws in the treatment of mandibular prognathism. Oral Surg Oral Med Oral Pathol 1982;54:2-6. https://doi.org/10.1016/0030-4220(82)90408-X
  2. Phillips C, Zaytoun HS Jr, Thomas PM, Terry BC. Skeletal alterations following TOVRO or BSSO procedures. Int J Adult Orthodon Orthognath Surg 1986;1:203-13.
  3. Komori E, Aigase K, Sugisaki M, Tanabe H. Cause of early skeletal relapse after mandibular setback. Am J Orthod Dentofacial Orthop 1989;95:29-36. https://doi.org/10.1016/0889-5406(89)90132-7
  4. Kobayashi T, Watanabe I, Ueda K, Nakajima T. Stability of the mandible after sagittal ramus osteotomy for correction of prognathism. J Oral Maxillofac Surg 1986;44:693-7. https://doi.org/10.1016/0278-2391(86)90036-4
  5. Will LA, Joondeph DR, Hohl TH, West RA. Condylar position following mandibular advancement: its relationship to relapse. J Oral Maxillofac Surg 1984;42:578-88. https://doi.org/10.1016/0278-2391(84)90088-0
  6. Van Sickels JE, Larsen AJ, Thrash WJ. Relapse after rigid fixation of mandibular advancement. J Oral Maxillofac Surg 1986;44:698-702. https://doi.org/10.1016/0278-2391(86)90037-6
  7. Epker BN, Wessberg GA. Mechanisms of early skeletal release following surgical advancement of the mandible. Br J Oral Surg 1982;20:175-82. https://doi.org/10.1016/S0007-117X(82)80035-8
  8. Reyneke JP, Ferretti C. Intraoperative diagnosis of condylar sag after bilateral sagittal split ramus osteotomy. Br J Oral Maxillofac Surg 2002;40:285-92. https://doi.org/10.1016/S0266-4356(02)00147-X
  9. Stella JP, Astrand P, Epker BN. Patterns and etiology of relapse after correction of Class III open bite via subcondylar ramus osteotomy. Int J Adult Orthodon Orthognath Surg 1986;1:91-9.
  10. Leonard MS, Ziman P, Bevis R, Cavanaugh G, Speidel MT, Worms F. The sagittal split osteotomy of the mandible. Oral Surg Oral Med Oral Pathol 1985; 60:459-66. https://doi.org/10.1016/0030-4220(85)90230-0
  11. Yellich GM, McNamara JA Jr, Ungerleider JC. Muscular and mandibular adaptation after lengthening, detachment, and reattachment of the masseter muscle. J Oral Surg 1981;39:656-65.
  12. Ellis E 3rd, Carlson DS. Stability two years after mandibular advancement with and without suprahyoid myotomy: an experimental study. J Oral Maxillofac Surg 1983;41:426-37. https://doi.org/10.1016/0278-2391(83)90127-1
  13. Chow LK, Singh B, Chiu WK, Samman N. Prevalence of postoperative complications after orthognathic surgery: a 15-year review. J Oral Maxillofac Surg 2007;65:984-92. https://doi.org/10.1016/j.joms.2006.07.006
  14. MacIntosh RB. Experience with the sagittal osteotomy of the mandibular ramus: a 13-year review. J Maxillofac Surg 1981;9:151-65. https://doi.org/10.1016/S0301-0503(81)80036-7
  15. Singer RS, Bays RA. A comparison between superior and inferior border wiring techniques in sagittal split ramus osteotomy. J Oral Maxillofac Surg 1985;43:444-9. https://doi.org/10.1016/S0278-2391(85)80053-7
  16. Kundert M, Hadjianghelou O. Condylar displacement after sagittal splitting of the mandibular rami. A short-term radiographic study. J Maxillofac Surg 1980;8:278-87. https://doi.org/10.1016/S0301-0503(80)80115-9
  17. Bell WH, Jacobs JD. Tridimensional planning for surgical/orthodontic treatment of mandibular excess. Am J Orthod 1981;80:263-88. https://doi.org/10.1016/0002-9416(81)90290-6
  18. Link JJ, Nickerson JW Jr. Temporomandibular joint internal derangements in an orthognathic surgery population. Int J Adult Orthodon Orthognath Surg 1992;7:161-9.
  19. Costa F, Robiony M, Toro C, Sembronio S, Polini F, Politi M. Condylar positioning devices for orthognathic surgery: a literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:179-90. https://doi.org/10.1016/j.tripleo.2007.11.027
  20. Gateno J, Miloro M, Hendler BH, Horrow M. The use of ultrasound to determine the position of the mandibular condyle. J Oral Maxillofac Surg 1993;51:1081-6; discussion 1086-7. https://doi.org/10.1016/S0278-2391(10)80444-6
  21. Bettega G, Cinquin P, Lebeau J, Rapha¨el B. Computer-assisted orthognathic surgery: clinical evaluation of a mandibular condyle repositioning system. J Oral Maxillofac Surg 2002;60:27-34; discussion 34-5. https://doi.org/10.1053/joms.2002.29069
  22. Politi M, Toro C, Costa F, Polini F, Robiony M. Intraoperative awakening of the patient during orthognathic surgery: a method to prevent the condylar sag. J Oral Maxillofac Surg 2007;65:109-14.
  23. Reitzik M. Skeletal and dental changes after surgical correction of mandibular prognathism. J Oral Surg 1980;38:109-16.
  24. Rodrlguez RR, Gonzalez M. Skeletal stability after mandibular setback surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;81:31-3. https://doi.org/10.1016/S1079-2104(96)80143-0
  25. Hunsuck EE. A modified intraoral sagittal splitting technic for correction of mandibular prognathism. J Oral Surg 1968;26:250-3.
  26. Epker BN. Modifications in the sagittal osteotomy of the mandible. J Oral Surg 1977;35:157-9.
  27. Wolford LM, Bennett MA, Rafferty CG. Modification of the mandibular ramus sagittal split osteotomy. Oral Surg Oral Med Oral Pathol 1987;64:146-55. https://doi.org/10.1016/0030-4220(87)90080-6
  28. Kim MJ, Kim SG, Park YW. Positional stability following intentional posterior ostectomy of the distal segment in bilateral sagittal split ramus osteotomy for correction of mandibular prognathism. J Craniomaxillofac Surg 2002;30:35-40. https://doi.org/10.1054/jcms.2001.0272
  29. Ellis E 3rd. A method to passively align the sagittal ramus osteotomy segments. J Oral Maxillofac Surg 2007;65:2125-30. https://doi.org/10.1016/j.joms.2007.02.005
  30. Koudstaal MJ, Poort LJ, van der Wal KG, Wolvius EB, Prahl-Andersen B, Schulten AJ. Surgically assisted rapid maxillary expansion (SARME): a review of the literature. Int J Oral Maxillofac Surg 2005;34:709-14. https://doi.org/10.1016/j.ijom.2005.04.025
  31. Motohashi N, Kuroda T. A 3D computer-aided design system applied to diagnosis and treatment planning in orthodontics and orthognathic surgery. Eur J Orthod 1999;21:263-74. https://doi.org/10.1093/ejo/21.3.263